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0-20472-A <br />(Ed. 10193) <br />WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY <br />NOTICE OF CANCELLATION OR MATERIAL CHANGE ENDORSEMENT <br />In the event of cancellaticn or other material change of the policy, we will map advance notice to the person or <br />organization nomad In the Schedule. The number or days advance notice Is shown in the Schedule. <br />This endorsement shad) not operate directly or Indirectly to benefit anyone not named In the Schedule. <br />Schedule <br />1. Number of days advance notice: 30 <br />2. Notice will be mailed to: <br />CITY OP SANTA ANA <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 92702 <br />G -204722-A Page 1 of 1 <br />(Ed. 1103) <br />REVIEWED BY: EUNICE HEREDIA {RG 7aF I() <br />